School of Medicine Dean Steven L. Kanter, M.D., has appointed Brandt Wible, M.D., interim chair of the Department of Radiology effective April 1, 2018. Under Wible’s leadership, the Department of Radiology will continue its important role in the School of Medicine’s undergraduate and postgraduate education and research programs.
Wible received his M.D. from the Rush Medical College. He completed his residency in diagnostic radiology at the Medical College of Wisconsin and a fellowship in interventional radiology at the Johns Hopkins School of Medicine.
Wible is a former United States Peace Corps Volunteer and is a member of the Alpha Omega Alpha Honor Society. He is the author of numerous peer-reviewed publications and textbook chapters and recently published a second edition of a textbook on interventional procedures in radiology. His clinical interests include oncologic and vascular imaging and treatment and clinical research at Saint Luke’s Plaza and Lee’s Summit Hospitals.
Kanter expressed his thanks and appreciation to Jeffrey Kunin, M.D., for his leadership as interim chair of the UMKC School of Medicine from 2016 to 2018.
According to the Alzheimer’s Association, more than 5-million Americans live with Alzheimer’s disease, which is the sixth leading cause of death in the United States. At UMKC School of Medicine, researcher Peter Koulen, Ph.D., has found an innovative way to diagnose the early stages of the disease – with an eye exam.
The test was developed at the School of Medicine’s Vision Research Center, where Koulen serves as director of basic research. It provides a non-invasive, fast-screening tool for early detection of Alzheimer’s and mild cognitive impairment, a precursor to Alzheimer’s.
Koulen’s work received a patent in January and has been attracting attention since. With support from the university’s Office of Technology Commercialization, it is now drawing interest from local manufacturers and diagnostic companies.
Koulen said the technology has received overtures from local investors interested in forming a startup company to license and further develop it, as well.
“There are business people now on our doorstep,” he said.
The test uses a microperimeter, a machine routinely used in eye exams to evaluate retina function, and typically takes less than half an hour.
And it is a relatively simple test for patients. One looks into the machine and presses a button when they see a flash of light. A computer program progresses through a series of flashing lights in various locations and intensities to measure the person’s retinal function.
“This is a technology that is already widely used by ophthalmologists,” Koulen said. “Over the years, we’ve found some different uses for it, and the Alzheimer’s diagnostics is one example of that. It’s basically a boring video game that you play for a few minutes.”
Because it was developed through clinical studies with patients and subjects, the transition from discovery to use in clinics could be relatively short. Compare that to other research, like creating a cancer drug, which could take decades of development.
“We’ve worked about half a decade on this,” Koulen said.
The technology evolved through researching therapies for glaucoma, macular degeneration and diabetic retinopathy, major eye diseases affecting the retina. These have been the focus of much of Koulen’s work at UMKC since joining the Vision Research Center in 2009.
The retina, a light-sensitive tissue, is part of the body’s central nervous system and is connected to the brain. Koulen and his team spent about seven years developing a still-growing database to define a baseline for healthy retina function. Using microperimetry, they were able to recognize subtle deviations from those baseline figures beyond normal aging. They linked those deviations to what they realized could be indicators of early-stage Alzheimer’s and mild cognitive impairment.
“We were able to pick up that these patients very likely had the neurological disorder before the neurologist was able to diagnose the very earliest forms of the disease,” Koulen said.
There is no single exam for diagnosing Alzheimer’s. The current method is an often cumbersome, time-consuming process of eliminating other potential causes of a neurological disorder. Results can be inconclusive until the disease has progressed to a more-advanced stage. By that point, treatment and patient care has become a primary concern.
A more rapid and conclusive diagnosis is possible with the test Koulen has developed. It can easily be given in a clinic or other settings. That could make the technology enticing for investors.
“The nice thing about conducting the diagnostics in the clinic is that they’re non-invasive,” Koulen said. “You don’t have to draw blood. You don’t need anesthesia. It’s basically a very complicated eye exam, but it’s still an eye exam.”
More than 100 people showed up on a warm February afternoon to take part in a golf outing that raised more than $9,000 to support the UMKC School of Medicine’s Sojourner Health Clinic.
Sponsored by the school’s National Board of Alumni and Partners, the Swinging for Sojourner event on Feb. 25 drew a broad group of supporters and golf enthusiasts.
“Our School of Medicine Alumni Board did a fantastic job creating this event,” said Fred Schlichting, School of Medicine Director of Advancement. “It was great to see UMKC alumni, students, friends and family swinging the clubs and having fun. It was a picture perfect day for an incredible cause.”
Participants filled 19 playing bays at the Top Golf facility in Overland Park, Kansas, and the banquet room after the golf competitions. A number of individuals and community partners, as well as UMKC athletics, UMKC Foundation and UMKC Charter Schools, pitched in to host teams or serve as event sponsors.
Tracy Stevens, M.D., president of the School of Medicine alumni association, welcomed the participants during the banquet. Merriam Massey, program assistant for Sojourner Clinic, also addressed the crowd. Second-year student Mrudula Gandham, one of the more than 200 student volunteers who help to operate the clinic, also spoke about the impact of Sojourner Clinic on the community and the education of UMKC students.
Sojourner Clinic opened in 2004 in downtown Kansas City to provide free health care for the inner-city homeless population. Each year, volunteers provide more than 1,500 hours of service to treat some of the city’s most vulnerable patients.
Since its founding, the clinic has expanded to include volunteers and services of students from the School of Medicine’s physician assistants program, the UMKC dental school, the physical therapy program at Rockhurst College and others.
“One of the major assets of Sojourner is collaboration. Our School of Medicine students had the foresight to include other schools and community partners to create and sustain a first-class clinic,” Schlichting said. “We need to take this same approach to this event. It will be a point of emphasis to invite all of our partners in the UMKC Health Sciences District to get involved with Swinging for Sojourner next year.”
Schlichting and tournament organizers offered a special round of thanks to tournament and team sponsors.
Dr. Corey Iqbal ’03
Dr. Diana Dark ’80
Dr. Tracy Stevens ’90
Dr. Ahmed Awad ’89
Dr. Valerie Rader ’05
Team Sponsors Dr. Susan Storm ’85
Dr. Lisa Fitzpatrick ’92
Dr. Steven Waldman ’77
Dr. Julie Brown-Longly ’00
UMKC Charter Schools Center
Truman Medical Center/University Health
Truman Medical Center Lakewood
Department of Community and Family Medicine
The Kansas City Medical Society recognized Richard Hellman, M.D., F.A.C.P., F.A.C.E., a former School of Medicine docent and clinical professor of medicine, with its 2017 Lifetime Achievement Award. It is the organization’s highest honor.
Hellman served as a docent for nine years before stepping down in 1981 to design and direct Kansas City’s first comprehensive program for adult diabetes care. The practice now includes a 21-member multidisciplinary team, emphasizing a patient-centered integrative approach linking education and medical care.
Hellman served on the board and as president of the American Association of Clinical Endocrinologists, which in 2016 presented him with its Outstanding Clinical Endocrinologist Award. He also has been active with the American Medical Association-convened Physician Consortium for Performance Improvement.
Founding editor of the AACE patient safety exchange web site, Hellman has also served as section editor for Internal Medicine World Report and a reviewer for many other journals.
He served as president of the Kansas City Medical Society in 2000 and in 2015 received the organization’s Innovation Award for his accomplishments.
Joshua M.V. Mammen, 2017 society president, said Hellman had helped to advance medical knowledge through his publications and service to national and international organizations.
“Dr. Hellman has been a leader and innovator in the practice of diabetes care and also in the areas of patient safety and performance measurement, both locally and internationally,” Mammen said.
The medical society recognized Gary Pettett, M.D., professor emeritus and a past associate dean for the School of Medicine with the same award. He received the organization’s 2016 Lifetime Achievement Award.
The Kansas City Medical Society represents medical and osteopathic physicians throughout the greater Kansas City area.
Former School of Medicine Dean Betty M. Drees, M.D., F.A.C.P., has been appointed president of the Graduate School of the Stowers Institute for Medical Research.
“We are fortunate to have recruited a physician-scientist of Betty Drees’ caliber to lead the Stowers graduate program,” said Robb Krumlauf, a member of the Board of Directors and scientific director of the Stowers Institute. “Her pioneering work in the study of type 2 diabetes mellitus and her experience training medical students in the art and science of biological investigation will prove invaluable in shaping our young scientists into tomorrow’s leaders.”
With more than 25 years in clinical practice, research, education, and administration, Drees is Dean Emerita and the immediate past dean of the School of Medicine. She served thirteen years in that role, from 2001-2014.
“It is an honor to be elected to lead the program at the Graduate School of the Stowers Institute,” said Drees. “The graduate school has a very committed faculty and talented predoctoral researchers, so I hope the administrative experience I bring can help them continue to grow. I want to help the researchers who join the program meet their career goals and get experience that prepares them for the future.”
Drees serves as an endocrinologist and a professor in the Department of Internal Medicine and the Department of Biomedical and Health Informatics at UMKC, roles she will continue to serve concurrently with her role at the Graduate School of the Stowers Institute.
Her interests center around community impact and improved quality of health care, such as prevention of diabetes mellitus and prevention of fractures. She leads a study on community interventions to prevent type 2 diabetes mellitus, titled “Reducing the Burden of Diabetes in the KC Area: Accelerating Innovation through Collaboration” and funded by the Health Care Foundation of Greater Kansas City. She currently serves as president of the Community Leadership Board of the Kansas City American Diabetes Association.
Students interested in emergency medicine took part in a day-long conference at the School of Medicine Clinical Training Facility, learning and practicing a variety of emergency procedures in the Youngblood Skills Lab.
The fifth-annual Emergency Medicine Interest Group Skills Conference drew 33 medical students who participated in work stations that included chest tubes insertions and Intraosseous infusion, lumbar punctures, suturing, emergency ultrasound, airway management, and emergency radiology.
Emily Hillman, M.D., assistant professor and emergency medicine clerkship directory, organized the conference with the help of interest group student officers Caroline Baghdikian, MS6, Joseph Bennett MS5, Deven Bhatia MS5, Jordann Dhuse, MS4, Brendan Kurtz, MS6, and Alie Reinbold, MS6.
A number of emergency medicine faculty members participated in leading the training sessions as well.
“The medical students truly value this experience,” Hillman said. “They put immense time and effort into planning this event. We will begin planning for next year soon.”
Violence tears apart too many young lives in minority communities, but interventions at crucial times can help reduce such violence and its effects, Dr. Michael Moncure said at the 2018 Dr. Reaner & Henry Shannon Lecture, held Feb. 23.
In his presentation at the UMKC School of Medicine, “Factors Associated With Interpersonal Violence in Minority Communities,” Moncure recounted anti-violence efforts from his career as a trauma surgeon. And he praised and drew hope from such recent efforts as Kansas City’s AIM4PEACE, which de-fuses violence with effective actions backed by research.
The direct results of violence are devastating, Moncure said, citing Centers for Disease Control statistics for 2015: 44,000 suicides; 17,000 homicides; and $107 billion in lost wages. In Kansas City, Missouri, he noted, homicides spiked in 2016 and remained high in 2017. The toll on minority communities can be devastating, and particularly tragic when young lives are lost or disrupted.
Moncure, a professor in the Department of Surgery at the School of Medicine, said his first job was in Camden, New Jersey, at the time notorious for crime and poverty. Moncure got involved with a program much like the TV show “Scared Straight,” which showed young people in high-crime areas how bad life could be if they committed violent crimes and were imprisoned.
“Those programs had some splash, but they weren’t evidence-based,” Moncure said. The programs ultimately were ineffective. “We even got a little cocky, and shared some of our materials with adults” in the criminal justice system. It was a reality check, he said, when those adults were unimpressed and even incredulous that Moncure and his colleagues thought their efforts would have any effect.
Research on violence and trauma and their causes and effects has come a long way since then, Moncure said, and trauma has come to be seen much more broadly than shootings or other violent crimes. Many studies have associated both recurring violence and adult diseases such as cancer, diabetes, heart failure and hypertension with the number and severity of someone’s ACES — adverse childhood experiences. ACES include poverty, divorce, and incarcerated parent, violence in the home and sexual abuse.
But research also has shown that interventions to support trauma victims at the right times can reduce the effects of such trauma and often prevent more violence.
For example, Moncure said one shooting often leads to another in retaliation. But an intervention specialist quickly summoned to a hospital bedside can help the wounded person and calm friends and relatives who might think they know who fired the shots and are bent on revenge.
In Kansas City, Missouri, Moncure said, the AIM4PEACE program specializes in such interventions, builds healthy relationships and gets results. Those efforts also are part of a community-wide plan that includes social support, counseling, job training and other efforts to combat violence. Another benefit of having research behind these efforts is demonstrating that they are cost-effective. Moncure believes this has helped get support from the Kansas City business community.
Thankful to be part of the annual Dr. Reaner and Mr. Henry Shannon Lectureship in Minority Health, Moncure noted that the series, developed to create awareness about health disparities affecting underserved and minority communities, encouraged exploring solutions to society’s problems.
Research indicating that stress from racism contributes to low birth weights and premature births was presented Feb. 22 at Children’s Mercy Hospital by Dr. James W. Collins Jr.
Collins, medical director for the Neonatal Intensive Care Nursery at Ann and Robert H. Lurie Children’s Hospital of Chicago, said pre-term birth rates in the United States had changed little in the past seven decades. The rate for African American women also has seen little change, remaining about 50 percent higher than for white women.
Collins’ presentation, titled “The Social Determinants of the Racial Disparity in Adverse Birth Outcomes: ZIP Code Eclipses Genetic Code,” reviewed several studies looking at possible causes or explanations for the persistent racial gap in low birth weights.
Those factors include age, education, income, upward economic mobility and geographic mobility, and they often correlate with rates of pre-term birth in predictable ways. For example, women living in low-income neighborhoods have more pre-term births than women in middle- or upper-income neighborhoods. But African American mothers in every type of income-bracket neighborhood still have higher rates of pre-term births than their white counterparts.
The results are much the same across the studies. Whatever factor is isolated and adjusted for, African American mothers still have higher rates of pre-term births. That leaves researchers looking for other causes, including racism and stress.
“Racism is kind of the elephant in the room,” Collins said. He presented research indicating that African American women who experienced racism more frequently and consistently in their lives were more likely to give birth prematurely.
“We are made to deal with acute stress pretty well,” Collins said. But when stress is chronic, such as from persistent racism, “you respond to acute stressors but you don’t come back down. I suspect this predisposes African American men to hypertension and African American women to pre-term birth.”
Collins said the biological mechanism for these ill affects was still unknown, but could be something that suppresses the immune system or otherwise fosters infections. But the exact mechanism doesn’t need to be known, he said, to see the problem as social rather than strictly medical, and to “go big” and “ecologic” in confronting and combating racism.
Medically, Collins said the day-to-day challenge for pediatricians is to provide comprehensive care for African American girls from before birth and to see them as potential mothers-to-be. Raising those girls for resilience, he said, while also working to change society, is work that requires everyone “to start slow and be tenacious.”
Collins closed with President John F. Kennedy’s reminder and exhortation that good and difficult work “will not be finished in the first 100 days … nor perhaps in our lifetime on this planet. But let us begin.” He then recited lines from Langston Hughes’ “Let America Be America Again,” with a gender switch:
O, let America be America again —
The land that never has been yet —
And yet must be — the land where every woman is free.
Sarah LaGrece has been selected as the new manager of the School of Medicine’s Medical Education Media Center. She will also serve as a senior operations technician at the Clinical Training Facility.
A graduate of UMKC, LaGrece will oversee the media center that serves as the School of Medicine’s instructional resource lab with anatomical models, and audiovisual and computer-based learning materials.
The media center will be open from noon to 5 p.m. during the week. Students can contact LaGrece to make arrangements to use the facility outside of the normally staffed hours. School administration is exploring options to provide additional staffing to expand these daily hours, she said.
In the meantime, LaGrece will be working on taking inventory, updating and repairing the models, and updating the computer software available for students, residents and faculty.
Her morning hours will be spent in the Clinical Training Facility, assisting with administrative duties, simulations with the facility’s mannequins, and helping with the standardized patient program.
A life-long resident of Kansas City, LaGrece graduated from Bishop Miege High School before attending UMKC and earning her bachelor’s degree in communications.
“I was thinking about being a teacher before I went into communications, so education was something I was always interested in,” LaGrece said. “So this seemed to mesh well with my interests.”
Really listening to patients and providing empathetic, compassionate care have always been a big part of the UMKC School of Medicine’s physician education. Next week those elements will get an extra boost from National Patient Solidarity Week.
The week, Feb. 12-16 this year, is sponsored by the Arnold P. Gold Foundation, a nonprofit organization that promotes patient-centered care. UMKC has had a chapter for 15 years and last month inducted more than three-dozen new members.
National Patient Solidarity Week activities are designed to strengthen the bond between patients and their physicians, nurses and other care givers. By increasing such engagement with patients, the program aims to enhance patient and staff satisfaction and improve health care outcomes.
For several years, members of the school’s Gold Humanism Honor Society chapter also have delivered roses and Valentines to Truman Medical Center patients on or near Valentine’s Day. And for the past three years, a “Tell Me More” activity during the week has emphasized medical students’ conversations that engage patients on important non-medical aspects of their lives.
Answers to some of the questions (such as “How would your friends describe you?”) are written on posters and hung at the head of each patient’s bed, so that everyone on the health care team has the opportunity to relate to patients in ways other than their clinical diagnoses.